CPT 64480 · Epidural · BCBS Tennessee
TFESI — Cervical/Thoracic (add'l level) at BCBS Tennessee.
How BCBS Tennessee approaches CPT 64480 (TFESI — Cervical/Thoracic (add'l level)) for prior-authorization review: at last review on 2026-02-12, the policy covers this code with prior authorization required.
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Coverage
Covered
Prior auth
Prior auth required
Last reviewed
2026-02-12
Policy number
BCBS-TN MPM (Epidural Steroid Injections)Criteria summary
High-level themes from the BCBS Tennessee policy of record for CPT 64480. Verbatim policy text and per-criterion analysis are available after sign-in.
- At least 4 weeks of conservative care typically required.
- Imaging concordance documentation required.
Source: BCBS-TN Medical Policy — Epidural Steroid Injections for Treatment of Back Pain
See the full BCBS Tennessee criteria.
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